Yingxin Liu, Zemin Li, Ruoting Wang, Jingyi Zhang, Hertzel Gerstein, Ai Zhao, Changfa Zhang, Gregory Y H Lip, Harriette G C Van Spall, Guowei Li
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引用次数: 0
Abstract
Background: The relationship between sarcopenia and type 2 diabetes mellitus (T2DM) among those with prediabetes is largely inconclusive given the heterogeneous findings of previous studies. We aimed to clarify the association between sarcopenia and prediabetes progression to T2DM in adult participants.
Methods: Participants with baseline prediabetes from the UK Biobank cohort were included in this study. Sarcopenia was classified as present or absent based on the criteria from the 2019 European Working Group of Sarcopenia in Older People (EWGSOP2 criteria) including handgrip strength, muscle mass and walking pace. The primary outcome was incident T2DM during follow-up. Multivariable Cox regression model adjusting for sociodemographic factors, lifestyles, comorbidities, and laboratory measures, was used to assess the association between sarcopenia and risk of T2DM.
Results: We included 60,325 participants (mean age: 59.6 years, 54.5% females) with baseline prediabetes for analysis, among whom 9,305 (15.4%) had incident T2DM during a mean follow up of 11.4 years. There were 7,139 (11.8%) participants categorized as having sarcopenia. Those with sarcopenia had a higher cumulative incidence of T2DM than those without (19.3% vs. 14.9%, P < 0.001). Sarcopenia was associated with a 22% increased risk of T2DM when compared with no sarcopenia (hazard ratio [HR] = 1.22, 95% confidence interval [CI]: 1.15-1.30) in the fully adjusted model. This association was more evident in participants with a waist to hip ratio < 0.9 (P-value for interaction < 0.05).
Conclusions: Sarcopenia was associated with increased risk of T2DM in adults with prediabetes. Sarcopenia appears to be a marker for risk of T2DM in people with prediabetes and interventions targeted at preserving and improving muscle health might be another novel potential approach to effectively decelerating prediabetes progression to T2DM.
背景：鉴于以往研究结果的异质性，在前驱糖尿病患者中，肌肉减少症与2型糖尿病（T2DM）之间的关系在很大程度上尚无定论。我们的目的是澄清成人参与者中肌肉减少症与糖尿病前期进展为2型糖尿病之间的关系。方法：来自英国生物银行队列的基线前驱糖尿病患者纳入本研究。根据2019年欧洲老年人肌肉减少症工作组（EWGSOP2标准）的标准，包括握力、肌肉质量和步行速度，将肌肉减少症分为存在或不存在。主要结局是随访期间发生T2DM。多变量Cox回归模型调整了社会人口因素、生活方式、合并症和实验室测量，用于评估肌肉减少症与T2DM风险之间的关系。结果：我们纳入了60,325名基线前驱糖尿病患者（平均年龄：59.6岁，54.5%为女性）进行分析，其中9,305名（15.4%）在平均11.4年的随访期间发生了T2DM。有7139名（11.8%）参与者被归类为肌肉减少症。骨骼肌减少症患者的T2DM累积发病率高于无骨骼肌减少症患者（19.3% vs. 14.9%）。结论：骨骼肌减少症与糖尿病前期成人T2DM风险增加相关。肌肉减少症似乎是糖尿病前期患者发生2型糖尿病风险的一个标志，旨在保持和改善肌肉健康的干预措施可能是另一种有效减缓糖尿病前期发展为2型糖尿病的新方法。
期刊介绍：
Diabetology & Metabolic Syndrome publishes articles on all aspects of the pathophysiology of diabetes and metabolic syndrome.
By publishing original material exploring any area of laboratory, animal or clinical research into diabetes and metabolic syndrome, the journal offers a high-visibility forum for new insights and discussions into the issues of importance to the relevant community.
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